1. When strep throat explains MS – vaccination to prevent EBV-complications? Summary: This Viewpoint proposes that Epstein-Barr virus (EBV) drives multiple sclerosis (MS) through a mechanism analogous to group A streptococcus (GAS)-induced rheumatic fever. Unlike GAS, EBV establishes latent infection with intermittent reactivation, which the authors argue sustains ongoing autoimmune activity through molecular mimicry. They cite infectious mononucleosis (IM) morbidity data: roughly 30% of university students contract IM, about 1 in 8 repeat an academic year, and children miss 1 to 3 weeks of school. No original clinical or epidemiological data are presented. The authors conclude that antiviral treatment of acute IM merits testing as primary MS prevention, alongside secondary prophylaxis in existing patients. Comment: EBV’s rap sheet already includes mononucleosis, Burkitt lymphoma, Hodgkin lymphoma, nasopharyngeal and gastric carcinoma, and post-transplant lymphoproliferative disease; MS may be the newest addition. Treating mononucleosis sounds reasonable, but why not prevent it outright? A licensed EBV vaccine could...
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